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路易莎・尼古拉常分享关于脑健康、运动科学和营养学交叉领域的启发性、实用性信息，是该领域最受欢迎的人士之一。阿尔茨海默病发病率正在上升，痴呆症病例在未来几年可能会激增，且这种疾病在症状出现前 20、30 甚至 40 年就已在大脑中悄然发生，请路易莎来探讨从现在开始可以采取的降低患病风险的措施。

路易莎指出全球约有 5000 万人患有这种疾病，到 2050 年病例数可能会增加两倍，这在她看来可能会导致美国医疗体系在经济上崩溃，原因令人担忧。一方面，这种疾病并非由基因决定，无论是否有风险基因，都可能患病；另一方面，教育存在缺口，很多人不了解痴呆症和阿尔茨海默病的区别，常将祖母的死因笼统归结为痴呆症，而实际上可能是小血管疾病、血管性痴呆、帕金森病性痴呆等。阿尔茨海默病之所以受关注，是因为在所有痴呆症中最为常见。

阿尔茨海默病与其他痴呆症的区别主要在于涉及 β- 淀粉样蛋白和 tau 蛋白两种机制。目前已知约有 30 种基因与这种疾病有关，其中只有约 3 种基因，如果存在突变，人就会患病，分别是早老素 1、早老素 2 和淀粉样前体蛋白。还有 apoE4 基因，apoE 基因有 2、3、4 三种类型，apoE4 基因的一个或两个等位基因会增加患病风险。路易莎认为，人们不必因携带 apoE4 基因而过度恐慌，无论是否携带，都有患病风险。

过去人们认为阿尔茨海默病是 β- 淀粉样蛋白级联假说导致的，即大脑中充满 β- 淀粉样蛋白会导致脑细胞分解和死亡，但事实并非如此。路易莎提出假设，认为在这种疾病的病理生理学中，有比 β- 淀粉样蛋白更早发生的事情。β- 淀粉样蛋白和 tau 蛋白可能只是 “犯罪现场” 的存在，而非引发疾病的原因。当它们在 “犯罪现场” 大量聚集且无法被清除时，就会干扰神经元网络，导致脑细胞死亡。

β- 淀粉样蛋白实际上是一种保护性分子，用于保护脑细胞，当先天免疫系统被激活时，比如人处于压力状态或存在神经炎症、慢性炎症时，脑细胞就会释放 β- 淀粉样蛋白来保护和屏蔽大脑。但由于它存在于脑细胞外部，即脑细胞在突触处相互交流的地方，如果不及时清除，两个脑细胞就无法交流，久而久之会干扰神经网络，导致记忆、思维、处理速度等方面出现缺陷，这也是阿尔茨海默病的早期迹象。

主持人补充说，那些导致疾病的突变基因携带者在阿尔茨海默病患者中占比很小，路易莎回应称仅占 1% 到 5%。绝大多数人的基因虽然可能增加患病风险，但并非决定性的，不会注定患病。apoE4 基因之所以会增加风险，是因为它会干扰大脑中的脂质代谢。

现代社会人们压力过大，收到短信等情况都会让人感到压力，向大脑发送受到攻击的信号，免疫系统被激活，大脑释放大量 β- 淀粉样蛋白进行保护。但问题在于，没有找到清除 β- 淀粉样蛋白的方法，比如在夜间如何清除，或者如何在睡眠中让大脑中的 “泵” 更好地清除它，路易莎认为这才是问题的根源，而炎症是其中的关键因素，且炎症的来源多种多样。

主持人提到，β- 淀粉样蛋白是大脑的一种保护机制而非缺陷，这一假说最早来自哈佛大学鲁迪・坦齐实验室的研究，他们发现 β- 淀粉样蛋白似乎会聚集在疱疹病毒周围，具有类似免疫功能，这也是疱疹疫苗有助于改善阿尔茨海默病和痴呆症的原因。

路易莎表示曾在社交媒体上分享过相关随机对照试验的结果，却遭到很多反对。其实不一定需要接种疫苗，关键是不要感染疱疹，单纯疱疹病毒 1 型与阿尔茨海默病风险增加有关，这确实与先天免疫系统以及大脑中的小胶质细胞（大脑的免疫细胞）的激活有关，小胶质细胞在睡眠时会通过类淋巴系统帮助清除 β- 淀粉样蛋白。

类淋巴系统是大脑的 “清洁” 机制，类似于身体的淋巴系统，在深度睡眠的第三阶段启动。当进入深度睡眠时，这些小胶质细胞会收缩，让大脑能够用脑脊液冲洗自身，带走包括 β- 淀粉样蛋白在内的所有废物。

tau 蛋白存在于神经元的轴突中并在那里积累，轴突是神经元细胞体延伸出来的部分，负责传导速度和传导速度。如果轴突开始崩溃，神经元就会受到双重影响，神经元自身死亡，同时神经元外部还会积累 β- 淀粉样蛋白。

主持人提到，有研究表明，在痴呆症症状出现前几年，大脑就会出现明显的萎缩，这些特征在悄然破坏大脑。

路易莎解释说，通过带有体积测量的 MRI 观察到大脑体积缩小，实际上是神经元连接的丢失，这与灰质体积有关。白质是神经元有髓鞘的脂肪部分，tau 蛋白会在那里造成干扰，而灰质体积的减少则与 β- 淀粉样蛋白的积累有关。

人类大脑有 1000 亿个神经元，每个神经元大约有 10 到 15000 个连接，形成庞大的网络。如果损失一百万个神经元，就会损失大量连接，这些连接在大脑的不同区域负责不同功能，比如枕叶的连接与视觉有关，颞叶的连接与听觉有关，这也是听力损失是认知障碍早期迹象的原因。

主持人询问如何保护自己，除了压力和炎症，人们每天应该采取哪些步骤来降低患病风险。

路易莎首先提到了性别差异，虽然她不倾向于性别歧视，但数据显示三分之二的阿尔茨海默病病例是女性，这很可怕且不公平，并非仅仅因为女性寿命更长，还与围绝经期和更年期雌激素的流失有关。

现在更年期问题受到关注，这很好，因为过去很多女性因 23 年前的女性健康倡议研究而害怕接受雌激素替代疗法（HRT），该研究存在缺陷，却让女性担心患乳腺癌的风险增加，而实际上终身风险极低。如今人们逐渐认识到该研究的问题，但很多女性如路易莎 70 岁的母亲，从未与医生讨论过更年期，也未被提供过激素替代疗法。

雌激素作为女性的主要激素，不仅与性欲或生殖有关，还是一种神经内分泌激素，大脑中遍布雌激素受体。雌激素在大脑中具有多种功能，是一种保护激素，能保护脑细胞免受压力等有害威胁，帮助管理身体、情感和心理压力，还有助于 BDNF 的增殖。如果大脑缺乏这种重要的激素，就会出现功能障碍。因此，路易莎建议女性，特别是 30 多岁末到 40 多岁的女性，找到一位更年期方面经过认证的优秀医生，了解这一过渡阶段，这是非常有力量的信息。

主持人分享了自己母亲患痴呆症的经历，其母亲也是因对 HRT 的恐惧而未接受治疗，而家族中没有乳腺癌病史，他认为这种疗法本可能有助于延缓或预防痴呆症，却因错误的科学观点而被拒绝，同时好奇还有多少类似的事情不为人知。

路易莎表示，HRT 并非适合所有人，关键是了解事实、了解自己的身体，并与合适的医生沟通。除了这一点，生活方式干预也很重要，虽然人们可能听腻了运动、晒太阳、保持健康、与积极的人相处等建议，但美国只有约 20% 的成年人达到了身体活动指南的要求，即每周至少 150 到 300 分钟的中等至剧烈体力活动，很多人长期久坐，而久坐堪比吸烟。

有一项针对女性双胞胎的研究，追踪她们多年，评估大脑体积和认知功能，让她们采用不同方案。其中一位双胞胎进行下肢锻炼，增强小腿肌肉的力量和爆发力。结果发现，腿部肌肉更强壮的双胞胎，大脑体积更大，认知功能更好，尤其是在情景记忆、反应时间和处理速度方面。这表明腿部肌肉大小与大脑大小之间存在直接相关性，且由于是双胞胎，基因因素已被控制。

这意味着人们需要开始热爱抗阻训练，很多女性对此感到害怕，觉得健身房令人生畏，但抗阻训练不仅对脑健康有益，还能减少 80 多岁时跌倒的风险。肌肉是葡萄糖的储存库，肌肉中含有肌因子，当收缩肌肉时，这些肌肉衍生的蛋白质会穿过血脑屏障，为大脑提供营养。

主持人认为抗阻训练与脑健康的关联是近年来才开始被讨论的，之前关于脑健康和运动的讨论主要集中在有氧运动上。

路易莎表示，这是因为现在有更多系统综述的证据表明，不同类型的运动为何会在功能性 MRI 上显示出差异，以及对脑叶结构的影响，甚至能减缓已被诊断为轻度认知障碍（痴呆前状态）患者的病情进展。虽然有人认为阿尔茨海默病可以逆转，但路易莎认为很难，目前还没有人能从阿尔茨海默病中康复，但可以通过运动延缓其发病。

主持人认同这一观点，认为阿尔茨海默病在症状出现前几十年就已在大脑中开始发展，一旦病理变化严重到出现症状，就难以逆转，就像 “火车已经离站”。同时，他强调要谨慎使用语言，避免使用 “逆转” 这样的表述。

路易莎提到了 lecanomab（仑卡奈单抗），这是一种 FDA 批准的用于阿尔茨海默病的静脉注射药物，能清除 β- 淀粉样蛋白，但并未使患者的基线认知功能恢复，还会导致脑组织损失，大多数患者出现脑微出血，甚至有死亡案例记录，且这种治疗费用高昂，每剂约 3 万美元，至少每月一次或每年四次。

主持人认为这一假说有一定合理性，但药物在清除蛋白的同时没有改善临床症状，反而增加了脑出血和死亡风险，应该放弃这种尝试，这让他想到了高密度脂蛋白（HDL）的例子，长期以来人们认为高 HDL 能预防心血管疾病，但药物人为提高 HDL 后，并未改善心血管结局。

路易莎补充说，过高的 HDL 可能还会增加患癌症的风险，HDL 只是健康的一个替代指标，并非因果关系。路易莎强调，脂质反映了身体的状况，不能采用一刀切的方法。既然 FDA 批准的药物效果不佳，就需要思考日常能做些什么。大量证据表明，抗阻训练、增强力量和肌肉对身体有益，能救命，肌肉在她看来是长寿器官，也是脑健康器官，这确实与肌因子有关。人们去健身房应该是为了大脑，锻炼过程中肌肉在张力下收缩，能增加流向大脑的血液，强化动脉，而肌因子就像大脑所需的天然免费药物。

主持人询问脑源性神经营养因子（BDNF）是否属于肌因子。

路易莎表示 BDNF 是最丰富和知名的一种，在讨论有氧运动时会涉及，而她现在提到的是 cathepsin B、irisin 以及 IL-6，IL-6 曾被认为是促炎细胞因子，但当它从肌肉细胞释放时，具有抗炎作用，能进入大脑缓解神经炎症，这对减少神经炎症这一导致疾病的重要因素很关键。肌因子是把双刃剑，《自然》杂志的一项研究显示，抗阻训练时肌肉细胞释放的肌因子能减轻前列腺肿瘤，因为身体和器官上有很多肌因子的受体。

主持人问运动是否可以被视为一种药物，路易莎表示这正是她的座右铭 ——“运动就是良药”。

要释放这些肌因子，需要在力量下收缩肌肉，因此需要一定的力量。路易莎通常建议人们举起自己最大负重的 75% 到 80%，这相当重，但如果坚持做 5 到 6 次，在第六次时保留约两次的余量，是可以做到的。

对于那些认为需要像健美运动员一样训练才能保护大脑的人，尤其是老一辈可能对此持怀疑态度，路易莎解释说，最健康的人寿命最长，最大摄氧量较高的人寿命更长，这说明运动有其道理。而且抗阻训练并非要每天都做，研究表明每周至少两次就足够，每次在健身房 45 分钟就能满足大脑健康的需求。最好的方式是学习复合动作，不要像健美运动员那样只练辅助肌肉，女性应该学习正确的深蹲、硬拉、卧推，这三个是最重要的动作，掌握正确方法后可以逐渐增加重量，这些复合动作能同时锻炼多个肌肉群。

主持人强调学习正确动作的重要性，因为社交媒体上有很多人因错误动作而受伤的案例。

路易莎补充说，女性的骨骼上有雌激素受体，更年期过渡期间，无论是否接受 HRT，都会因雌激素流失导致骨密度降低，出现骨量减少和骨质疏松，抗阻训练能刺激骨骼，有助于改善骨密度。新西兰的研究人员对绝经后女性进行了一项为期 10 周的研究，让她们每周三次，每次跳 10 分钟，不使用负重，就原地跳，结果让骨量减少的女性恢复到了正常骨密度。

路易莎的母亲骨密度 T 值为 - 2.5，低于同龄人的平均值，她让母亲每天跳 10 分钟，有协调性的话可以用跳绳，她自己在 2020 年学会了跳绳，并不容易，需要大脑和多种肌肉的配合。

路易莎还提到，很多女性花太多时间做高强度间歇训练（HIIT），从运动生理学的心率区间来看，1区是静坐状态，5区是最大心率，接近呕吐的状态， 2、3、4 区介于两者之间。很多女性在3 和 4 区花费时间，这其实是浪费时间，比如在 “橙色理论” 健身课程中，45 到 60 分钟内不在稳态的2区，而是在3 和 4区，却不在5区，这只会产生更多皮质醇。绝经后或围绝经期女性由于雌激素水平降低，炎症标志物本就较高，这种训练会让她们承受更多压力，对长期的健康和心肺功能并无益处。

女性需要进入5区，即高强度运动，这能提高最大摄氧量。绝经后女性在更年期患心脏病和心血管疾病的风险会增加两倍，因此在这个区间锻炼对心脏的保护作用比在3 和 4 区更有益。虽然5区 听起来比 “橙色理论” 课程更难，但实际上只是短暂的爆发，比如 4 分钟运动，3 分钟完全休息，重复 4 次就完成了。

主持人以自己做战绳为例，最高强度只能维持 45 秒，

路易莎解释说这可能是肌肉疲劳而非心率问题，如果在台阶机上做最大心率训练，可能能维持更长时间，所谓的 4 分钟运动，其实需要大约 1 分钟才能让心率达到该水平，真正处于最大心率的时间约为 1 分半钟。对于战绳或动感单车，总时长 4 分钟，高强度运动几秒后休息，再重复几次也是可以的，休息时必须完全停止，休息 3 到 4 分钟。

“挪威 4×4” 训练法是提高最大摄氧量的黄金标准，研究表明，1 分钟运动 1 分钟休息的方式也能提高最大摄氧量，但效果不如前者。

主持人认为这是个好消息，因为很多人可能会误以为必须把健身当成全职，

路易莎表示自己也没有把健身当全职，但会投入很多时间，不过在某些有氧区间的锻炼上也有所欠缺，比如自己做了很多2区 训练和抗阻训练，但5区 的训练不够。很多女性也在2区 花费时间，这是因为2区 训练很流行，癌症代谢专家伊尼戈・圣米兰也提到了这一点，但2区 训练主要针对男性，女性不需要在2区 花费太多时间，应该把时间用在抗阻训练、跳跃和区 训练上，区 训练应该作为补充，比如周末有空时和孩子骑车、长时间散步，而不是作为周二早上的专门锻炼时间。

关于每日步数目标，路易莎认为步数与寿命和阿尔茨海默病都有很强的相关性，每天至少走 8500 步是不错的，而且外出还能同时晒太阳。

主持人想谈谈营养，提到最近有一个令人乐观的头条新闻，称现在正处于 “沙丁鱼女孩之夏”，沙丁鱼在社交媒体上成为热门食物，据说有助于预防阿尔茨海默病、心血管疾病等，询问路易莎对这一潮流的看法。

路易莎表示喜欢这一潮流，因为让人们意识到多脂鱼对大脑有益。大脑重约 2 磅，消耗摄入总热量的 20%，由脂肪和蛋白质构成，约 60% 的大脑由脂肪酸组成，其中 10% 到 15% 是 omega-3 脂肪酸，特别是 DHA，来自三文鱼、沙丁鱼、鲭鱼等多脂鱼。

DHA 对阿尔茨海默病有影响，一方面它进入脑细胞的细胞膜，从多方面保护脑细胞，具有很强的抗炎作用；另一方面有助于细胞膜的流动性，在细胞间传递信号时，细胞膜流动性好，神经递质（如血清素、多巴胺、负责镇静的 GABA 等）的突触传递就更好，所有认知领域都会受益于更强的神经传递。

EPA 对心脏更有益，DHA 对大脑更有益。ALA 是植物来源的 omega-3 脂肪酸，需要转化才能进入大脑，但转化率很低，DHA 是必需脂肪酸，人体无法合成，必须从食物中获取才能丰富大脑中的 DHA 含量。

比尔・哈里斯博士的实验室研究表明，omega-3 指数达到 8% 或以上，至少能延长 5 年寿命。美国的平均 omega-3 指数约为 4% 或更低，而日本的平均 omega-3 指数为 8% 或更高，巧合的是，日本的预期寿命比美国长 5 年。

路易莎建议检测 omega-3 指数，这是一个简单的指尖采血测试，能了解 omega-3 与 omega-6 的比例等基线情况。随机对照试验显示，对 176 名老年人每天给予 1 克 DHA，他们的认知功能在速度、处理能力、情景记忆等方面有显著改善；对约 485 名老年人补充 900 毫克 DHA，也有积极效果。路易莎认为每个人每天至少应摄入 2 克 DHA 和 2 克 EPA。

沙丁鱼成为潮流，是因为富含 omega-3 脂肪酸，汞含量低，价格不贵，容易获得。现在罐装鱼在社交媒体上很流行，包装也更精美，甚至有知名品牌推出自己的鱼产品，价格也因此上涨。但并非所有人都喜欢沙丁鱼的味道，而且选择鱼类时要注意来源，养殖鱼可能营养成分不足，因为通常被喂食类似宠物食品的颗粒。

对于 omega-3 脂肪酸补充剂，由于补充剂行业监管不严，很多产品因储存不当而变质，且来源不明，所以选择时要确保公司进行第三方检测。

有人比较了从品牌官网和亚马逊购买的同一款 Thorn 补充剂，标签和外观完全相同，但瓶子不同，这意味着有人复制了标签，可能在里面装入劣质成分，所以在亚马逊购买补充剂要谨慎，最好从制造商官网购买，且品牌要有多个管理机构的第三方认证，如 NSF 认证等。路易莎使用的鱼油是 IO 认证的，经过多种检测，确保纯度、 potency 等，尤其是氧化程度，因为 omega-3 脂肪酸很容易被氧化。

主持人分享了自己关于坚果的 “争议性观点”，认为核桃因外形类似大脑而被认为是健脑食品，但实际上并非如此，山核桃可能更好，而他认为最有益脑健康的坚果是开心果和杏仁。

杏仁是镁的重要来源，一份杏仁能提供每日镁需求的 25%，镁对 DNA 修复和能量生产很重要，且杏仁富含维生素 E，这是一种对大脑很重要的抗氧化剂。核桃的卖点是富含 omega-3 脂肪酸，但属于植物性 omega-3，转化率低。 关于坚果上的霉菌问题，虽然有人担心，但观察发现吃坚果的人健康状况更好，所以不必过于担心。

开心果的特别之处在于它是唯一含有叶黄素和玉米黄质的坚果，这两种类胡萝卜素作为抗氧化剂对脑健康也很重要，开心果的黄绿色就来自这些植物色素，其他坚果则没有。有消息称迪拜因 “迪拜巧克力”（一种内含开心果碎的巧克力）而出现开心果短缺，这种巧克力看起来很美味，让人难以控制食用量。

主持人询问路易莎除了 omega-3，购物车中还有哪些考虑脑健康的食物。

路易莎会购买蓝莓，多项研究表明蓝莓的多酚对大脑有益；她还关注橄榄油及其相关争议，虽然 “初榨” 或 “冷榨” 的说法并不准确，但橄榄油对整体脑健康、身体健康和长寿都很有益；她也吃很多红肉，认为红肉是很好的健脑食品；她是杂食者，饮食以全食物为主，每天会吃一点巧克力，黑巧克力也被认为是健脑食品，她吃的是 60% 纯度的，不是 70% 的；她不抽烟、不喝酒，从不吃加工食品。

主持人问路易莎除了主观感觉自己状态好，是否会定期检测认知健康。

路易莎会做很多事情，比如美国现在有一种血液检测，可以通过血液检测大脑中的 β- 淀粉样蛋白和 tau 蛋白，其效果几乎与 PET 扫描或脊髓穿刺相同。过去诊断阿尔茨海默病需要通过脊髓穿刺获取脑脊液来测量 β- 淀粉样蛋白含量，现在通过血液测试就能做到。

有一个 50 岁的人通过血液测试发现有少量 β- 淀粉样蛋白和 tau 蛋白，她打算进行血浆置换，即抽出多升血液，分离红细胞和血浆，去除含有杂质的血浆，再将红细胞放回体内，这样可以清除 β- 淀粉样蛋白和 tau 蛋白，布莱恩・约翰逊做过很多次，展示的血浆袋是完全黄色的。路易莎自己做了检测，结果为零，但她也在考虑做血浆置换。

去年 9 月，路易莎做了全身 MRI，结果很好，只是发现甲状腺有一个小结节，肺部也有一个小的良性结节，她通过超声进一步检查了甲状腺结节。99% 以上的结节都是良性的。

澳大利亚政府从 2026 年开始将为肺部低剂量 CT 扫描付费，因为越来越多的年轻人被诊断出肺癌，无论是否吸烟，这很令人担忧，因为吸烟者可能一生都不会患肺癌，而非吸烟者却可能患病。

路易莎认为自己并非偏执，只是提前做好预防，她觉得观察 omega-3 指数的变化很有趣，两年前她的指数是 10.5，今年是 11.6 左右，说明她采取的一些措施是有效的。她还进行很多认知训练，包括基于脑体的锻炼。比如用一个网球和一个眼罩，遮住一半大脑，把球扔到墙上，做各种动作来提高反应时间、处理速度和协调性，甚至根据灯光信号决定是否扔球，这对她很有帮助。

主持人提到几年前听说单脚平衡能力是长寿的标志，路易莎认为这很有趣，因为小脑（位于大脑下方，连接脑干）参与姿势、平衡和控制，在阿尔茨海默病中也可能会退化。

主持人担心这些血液检测是否会因让人紧张而适得其反，比如自己发现甲状腺结节时，虽然知道自己很健康，但在超声确认良性之前还是很担心。如果血液检测发现大脑中有斑块，该怎么办，是否会造成恶性循环。

路易莎认为这取决于个人，做 MRI 本身就不太舒服，可能会让人害怕，发现问题后可能会找很多医生，但如果发现的问题最终无关紧要，也会带来困扰。所以要做好心理准备，对于想进行 APOE4 基因检测的人，有遗传咨询服务。有一位女性因母亲患有亨廷顿舞蹈症而害怕做检测，因为她有两个孩子，担心如果结果呈阳性，会影响与孩子相处的时间。

对于 APOE4 基因携带者，需要积极管理脂质，研究表明 LDL 低于 75 可能就足够了，可能需要服用他汀类药物，对于家族性高胆固醇血症患者，可能也需要服用他汀类药物来降低胆固醇，因为其他方法可能无效，这些都可以与医生讨论。

美国还有 Grail 测试，虽然还处于初期阶段，但可以检测不同的肿瘤标志物，成像技术虽然是黄金标准，但仍有很多东西无法通过成像看到，如胰腺癌、卵巢癌等。

主持人是 APOE4 基因携带者，LDL 在 80 到 90 之间，处于正常范围的高端，他认为饮食对这些指标的影响可能被夸大了，饱和脂肪对 apo 的影响比其他营养素大，但不同饱和脂肪酸的影响不同，且在全食物中，比如红肉中 50% 的脂肪是油酸（单不饱和脂肪），如果为了减少饱和脂肪而戒掉红肉等食物，可能会错过很多营养，全食物植物性饮食并非没有风险，红肉是营养密度很高的食物。

路易莎同意这一观点，认为与其关注摄入什么，不如关注没有摄入什么，比如大多数美国人维生素 D 含量低，而维生素 D 的前体是镁，镁来自植物的叶绿素种子，人们是否摄入了足够的镁，是否晒太阳获取了足够的维生素 D。人们太关注下一种可以服用的补充剂，而忽略了这些基本营养素。

路易莎分享了一个经历，在一次关于最大摄氧量与长寿的演讲后，有人问她有什么补充剂可以提高最大摄氧量，这说明大多数人在寻找捷径，而实际上并不存在这样的补充剂。主持人提到可可碱可能有助于促进一氧化氮通路，但这与提高最大摄氧量不同，只是增加血液流动。

最后，主持人问路易莎 “过天才般的生活” 对她来说意味着什么，

路易莎回答是坚持自己的目标，无论目标是什么，因为坚持目标需要每天努力投入生活，如果能在这方面做到出色，就能过上最好的生活。

How to Protect Your Brain, Bulletproof Your Mind &amp; Prevent Alzheimer’s - Louisa Nicola

</markdown>

D:2025.08.13<markdown>

Louisa Nicola, what's up? Welcome back

to the show. How you doing?

So excited to be here. Part two.

I know. Part two. Uh, well, you're one

of my favorite people in the space.

You're always sharing such illuminating

and helpful, actionable information at

the intersection of brain health and

exercise science and nutrition. So,

there's a lot to unpack cuz Alzheimer's

rates are on the rise.

Numbers with regards to dementia

incidents are set to explode in the

coming years. And this is a condition

that begins silently in the brain 20,

30, maybe even 40 years prior to the

onset of symptoms. So there's no better

expert than you to have into the show to

unpack the ways, the steps that we can

take starting today to reduce our risk.

Yeah, definitely. And it's so

interesting, right? You just said, you

know, around 50 million people worldwide

have the disease. Why is it going to

triple by the year 2050? That's the

statistics, right? which in my opinion

is going to be the collapse of the US

healthcare system economically.

Uh you know just what it's going to cost

to overcome that. Um it's scary for for

many reasons. One is it's not

genetically determined. So it doesn't

matter if you have the risk genes or

not, you probably can still, you know,

still get the disease. Secondly is it's

quite sad because I think we've got an a

gap in the education, right? Because so

many people still don't understand what

dementia is. They don't understand what

Alzheimer's is. I I speak to people

every day that say to me, “My

grandmother died of dementia.” I'm like,

“Did she really?” And they're like, “I'm

not sure.” And sometimes it could be

small vessel disease, vascular dementia,

Parkinson's dementia. So the reason why

we hear about Alzheimer's is because out

of all of the dementias, Alzheimer's is

the most predominant one.

Quite scary. And it differentiates

itself from the other ones because it's

primarily

you know the two mechanisms involved is

beta amalloid and tow proteins. So we

can unpack that but before we do I'm

going to tell you this. There's around

30 genes that we know of now. Oh maybe

there's probably a bit more than that

but we can safely say there's around 30

genes involved in this disease. Only

around three of them. If you do have

these you will get or you have a

mutation in these three genes you will

get the disease and we know that that's

pinylin one pinelin 2 and the amaloid

precursor protein if we have the

genetic mistake I would say mutation

then we'll get that then we've got the

apoE4 gene so we've got apo2

3 and four and I know you've spoken

about it a lot but the apo4 genes if we

have one alil or if we have two alils,

it raises our risk of getting the

disease. And I always describe this cuz

people get so scared. They're like,

“Should I know my should I know it?” And

I'm like, “Well, it's great if you can

go and get a genetic test, but to to see

if you're um an ApoE4 carrier, but even

if you are or even if you aren't, you

are still at risk of getting the

disease.”

So let's unpack why people are getting

the disease. Why it's it's we're getting

people in their early 50s which is early

onset Alzheimer's disease.

We have to understand why. So first of

all if we know that amalloid

and tow okay the two hallmarks of

Alzheimer's disease we used to think of

Alzheimer's disease as the amaloid

cascade hypothesis. you know, we'd get

this head full of amaloid and that's

what's going to cause us to break down

and and lose brain cells. Doesn't turn

out that it turns out that amaloid isn't

the demon yet.

Yet, I believe that's my hypothesis,

right?

That there's something earlier that

occurs in the pathophysiology

of this condition. It's not the amaloid.

The amaloid is perhaps and the tow are

perhaps there at the scene of the crime,

but you're saying they're they're not

necessarily

the causal instigators. They get to the

crime, but they don't leave.

And that's what ends up being like when

there's too many people coming to the

crime and you're not ushering them out,

then they just stagger. And when they

stagger, they end up, you know,

involving themselves in the neur

neuronal network and killing off your

brain cells that way. But what tends to

happen is let's take take a look at what

this is. It is actually a protective

molecule, right? And it's there to serve

and protect your brain cells. And it

actually gets activated whenever we

activate the innate immune system. So

where whenever we're stressed right this

stressed or we've got inflammation,

neural inflammation, chronic

inflammation, the brain cells are going

to release this amaloid to protect and

shield the brain. And it does do so,

right? It basically comes up, it shields

the brain, protects the brain cells. But

since it's occurring outside of the

brain cells where the brain cells kind

of communicate with one another at the

syninnapse, what happens is if they

don't leave, these two brain cells can't

communicate anymore. So it ends up

interfering with this network. And over

time, what happens? Well, if one brain

cell can't communicate with the other

one and form a synaptic connection, what

do we see? We see deficits in memory,

thinking, processing speed. And that's

the first signs of Alzheimer's disease.

Yeah. And I just want to also double

click on something that you mentioned

earlier that these the mutation genes

like that

might sound scary but those the people

who who carry those genes make up a very

small proportion of the

Alzheimer's disease population.

1 to 5%.

Wow.

Yeah.

So the vast majority have genes that are

while they may increase your risk,

they're not deterministic. They're not

genes that basically,

I guess, for lack of a better uh way to

put it, they don't seal your fate.

Correct. It's not a foregone conclusion.

If you have these genes, if you have a

genetic mutation on chromosome 4, you

will get Huntington's disease, but

that's a different story. But for the

apoE4 gene, really what it does is the

reason why it raises your risk is

because it interferes with lipid

metabolism in the brain, right? And

we'll talk to we'll talk about that. So,

we've got this society now that is hyper

stressed. We're hyper stressed. We see

notifications. We get stressed. We send

a signal to our brain that we're under

attack. What ends up happening is your

immune system becomes activated because

it sees a threat. And that's well and

truly what it really is. It's a threat.

So, your brain releases all this amaloid

to protect it. But we're not getting to

the root of that which is how do we

clear out that amaloid at night or how

do we have a better pump in our brain

during sleep to clear the amaloid out.

We're not doing that. And that's what I

think is at the root of it if you could

nail it down. I think at the root of it,

it is inflammation

and inflammation can come in many ways,

right?

Yeah. It can come in many ways. is I

mean this the whole like amalloid being

a protective

feature not a bug but a feature of the

brain is I mean I think the first time

that I became aware of that hypothesis

was from the work at Rudy Tanzy's lab at

Harvard where they were looking at how

amaloids seem to aggregate around the

herpes virus.

Yeah.

So like it it actually has sort of like

a like an immune function in the brain.

And this is why the herpes vaccine is

actually showing that it's helping with

um Alzheimer's and dementia.

Yeah. So, I put that out there on social

media and it got a lot of kickback. Um

so, I was just uh putting out there what

the the randomized control trials

actually show.

Well, yeah, you don't necessarily need

to get the vaccine, but just don't get

herpes.

Yeah, exactly. Just don't get herpes,

right? So, so let's let's let's just

like

and by the way, also it's probably wise

to say like do we do we know whether or

not herpes increases risk for

Alzheimer's or it's like that connection

herpes simplex one. Well, yeah, that's

the connection.

Yeah. And that's really due to the

innate immune system and it's because of

the activation of these micro GA which

is also you know that's the the immune

immunity cells in the brain and that's

the thing that is actually going to save

you from the amaloid because it's also

going to go to work and clear it out

during sleep because of the glimpmphatic

system.

Wait the glimpmphatic system. So that

the glimpmphatic system is basically

your brain's housekeeping.

Yeah. Mechanism. So just like our

lymphatic system in in the body, we've

also got the glimpmphatic system. And

this kicks in during stage three deep

sleep. So when we go into deep sleep,

this lymphatic system comes al

it's so it's really magical, right?

because I've actually seen it in a in a

PSG. But um what happens is these little

gal cells, they actually shrink allowing

the brain to wash itself out with the

cerebral spinal fluid and it takes with

it all of the debris including amaloid

beta.

That's so dope.

Yeah. So it clears it out. But remember,

you've got amaloid beta which lives

outside of the neuron and it interferes

with the with the synaptic transmission.

But then you've got tow proteins and the

tow protein actually lives and

accumulates in the axon of the neuron.

And the axon is the part of the neuron

that comes off of the cell body and is

responsible for conduction speed and

velocity. So if that starts to collapse

the neuron, then you've got a two-fold

effect. You've got the neuron dying

itself, the brain cell itself, and then

you've got the accumulation of amaloid

outside of the neuron as well. It's a

one-two punch.

Yeah.

Yeah. I've uh read that the brain can

shrink that there's marketked shrinkage

in the brain even even years prior to

dementia symptoms, the onset of symptoms

that that these features are I guess

silently strangling.

Yeah. Because what ends up happening is

when you look at this on if you do an

MRI with volutrics and you're measuring

the volume of the brain and it seems to

shrink, what you're actually seeing is

you're seeing the connection loss

because that's what the gray matter

volume is. The white matter, which is

the myelinated fatty part of the neuron,

that's where you're actually seeing the

tow protein interfere with it there. But

the the gray matter is what is actually

accumulating in that loss of volume from

the amaloid.

Wow.

Yeah. Because you have to think we've

got a 100red billion neurons in the

human brain each containing around 10 to

15,000 connections.

If you do the math on that, that's a

huge network operating.

If you let's just say you kill off a

million neurons,

how many you know how many connections

is that? That's a million times 15,000.

So those 15,000 connections start

somewhere in the brain and those 15,000

connections are responsible for

something depending on where it is. It

could be in the occipital lobe which

would be responsible for vision, right?

Could be in the temporal lobe which

would be responsible for hearing and

this is why hearing loss is an early

sign of cognitive impairment.

Okay. So how do we then so how do we

protect ourselves? I mean what's so you

mentioned stress don't you know

obviously like in inflammation plays a

plays a major role but what are the

steps that people should take be taking

every day then to

if not altogether prevent that they will

ever one day be diagnosed with this

condition to at least reduce their risk.

Yeah. Well, let's unfortunately be

sexist right now, which is not something

that I I tend to do, but in this case,

we will because two out of three

Alzheimer's cases are female, which is

quite scary and unfair. Speaking about,

you know, cuz I am a female myself. It

is unfair.

It is unfair, right? And you have to ask

why. And what we you know we used to

think it's just because women live

longer but it's actually because of uh

the loss of estrogen that occurs during

permenopause and menopause. And what I

love menopause is being spotlighted

right now. And I love that because we I

feel so sorry for the women who were

scared out of taking estrogen hormone

replacement therapy because of the

women's health initiative which occurred

23 years ago, right? which was this huge

study that basically with

I think it was flawed completely which

basically scared women out of taking HRT

because of the increased risk of breast

cancer which actually I think don't

quote me which was like one in 10,000 is

that correct yeah

for women the yeah lifetime risk

lifetime risk yes

and that's extremely

yeah high low risk I mean to to scare so

many women away from this

potentially life-changing therapy Yeah.

When Yeah. when incident was so low

when the incidence was so low and so

we've fixed that up now. I think the

world is now coming to terms with okay

that wasn't true. So what do I have to

do? But then we've got you know my

mother included who just turned 70 years

old who was part of that. She's never

she doesn't even know when she went into

menopause never had the discussion with

her physician about she was never

offered hormone replacement therapy.

Right. So she's part of that. But I

think you know when I go through it in

20 years then that's going to be a

different story. So why is it that

though? But why what does it what does

estrogen have to do with the brain?

Estrogen being our predominant female

hormone is not just a heo it's not just

a hormone of libido or reproduction.

It is a neuroendocrine

hormone, meaning that we have receptors

all over our brain. And receptors and

hormones are like key unlocks, right?

So, we've got all these receptors on our

brain ready for estrogen. And estrogen

serves as many functions in the brain.

One thing that it does is it's a

protective hormone. It protects the

brain cells against these harmful

threats, stress. So we are better able

to manage stress physically,

emotionally, mentally when we have an

abundance of estrogen in the brain. It

helps with the proliferation of BDNF,

which we'll get into. So it helps BDNF

fertilize the brain, if you will. So it

just does so many different things in

the brain. So if we starve the brain of

an essential quote unquote nutrient or

hormone, then of course we're going to

see some dysfunction, right? So, we've

got that to deal with as well. So, going

back to your other question, what can we

do with this? The first thing I would

recommend for females specifically is

finding a really good provider, someone

who is menopause certified, if you will,

who can actually talk to you about this

transition.

I think that that's the first thing that

every woman in their late 30s going into

their 40s should equip themselves with.

Super empowering information. And I mean

my my mom who had dementia as you know

she was um part of that cohort of women

I guess which was which comprised most

women that were really afraid of of of

HRT for fear of breast cancer. But

the irony is that I don't have a

familial history of breast cancer.

Exactly.

So

the notion that this therapy could have

potentially helped my mom and stave off

dementia or prevent it altogether. I

mean, and and that that was something

that she

uh turned down or at least wasn't wasn't

interested in because of this this

dogma,

this shoddy science.

Yeah,

it's very sad.

And how many other things that we don't

know about yet that are probably in the

same boat, right? So, now that we know

that women can protect their brains by,

you know, and by the way, I'm not saying

that it's HRT is for everybody. It's

just knowing the facts and knowing your

body and getting on with the right

physician. That's the first thing. And

then what else can we look at? We can

then turn to lifestyle interventions,

which I know people are probably so sick

of hearing.

Exercise, sunlight, good health,

surround yourself with positive people.

But then why, you know, we're still not

doing that. I think we're still at only

like 20% of the US population, US adult

population are exercising.

How? What percent? 20 I think around 80%

um which was released from the CDC is

meeting the physical activity

guidelines.

Wow.

Yeah. Which is a minimum of 150 minutes

to 300 minutes per week of moderate to

vigorous physical activity.

Damn. Some people are just chronically

sedentary.

Yeah. And sitting is the new smoking.

And so, uh, there was a really great

study, um, it was a twin study on

females and they tracked them, two

female twins and they tracked them over

a long period of time and they were

really assessing brain volume and they

was assessing cognitive function and

they put them under two different

protocols. One twin was to do lower body

workouts. Okay, so basically building

the lower leg muscles for strength and

power, right? All right. So strength and

power are two different things

basically. Obviously we know what

strength is and power is just how much

force can you exert um under a set

period of time. So

over the course of I think it was it was

a number of years. But what they found,

they tracked them was the woman, the

twin who had greater leg muscles, had

greater brain volume and size and

greater cognitive functions,

specifically in the domains of episodic

memory, reaction time, processing speed.

Damn.

So there is a direct correlation to how

big your leg muscles are and how big

your brain is.

And these were twins. So their twins

genes were controlled for.

Exactly. So, two twins. And so, what

does that mean? Well, that means that we

have to start to fall in love with

resistance training. Many women are

scared to do it. I get it. It's daunting

going into the gym. It is because you

see a lot of people who are, you know,

men who are lifting. We have to get into

doing resistance training. And that's

not just for the brain health benefits.

That's to potentially mitigate a fall

that could occur when you're in your

80s. That is because we know that um

muscle is a storage sink for glucose. We

know that muscle is doing more than just

having those benefits. We know that

within the muscle itself, they contain

myioines. Myioines are muscle-based

proteins that when you are actually

contracting your muscles, you're

releasing these proteins which cross the

bloodb brain barrier. They go in and

help feed your brain.

It's amazing.

Yeah.

So, resistance training is is crucially

important, but that's I feel like that's

something that's like Would you agree

that that's kind of an people are now

talking about resistance training in the

context of brain health? It's like a

it's like a recent

Yeah.

conversation. Yeah. It's a conversation

that only sort of started to emerge in

the um within the scientific community

and within the public at large only just

over the past like couple of years. Like

that was not

prior to that the conversation

around brain health and exercise was I

think dominated by like cardio

I know right and that's because of um we

now have more evidence from systematic

reviews to show like when we do these

types of exercises why do we see a

difference in the fMRI functional MRIs

and why do we see a difference in the

brain lobe structure and we can we can

see them and not only that we can

actually see the positive effects of

slowing down mild cognitive impairment

with people who have been diagnosed

which is it's a predment state and we

know that with Alzheimer's disease we

can't reverse it. I'm not I know that

there is a physician who believes and he

probably has you know seen the reversal

of Alzheimer's disease. I think that

that's really still difficult for me to

symptoms understand

or like a slowing. Yeah. Nobody's ever

nobody's ever recovered from

Alzheimer's.

No, exactly. But um I believe you can

you you can slow the the onset of

Alzheimer's disease, right? And it is

really done through exercise itself.

I agree. I think that we've just got to

be a lot more uh careful about the

language that we use. But the the idea

that some people are out there using the

term reversal for Alzheimer's disease,

like once you understand that

Alzheimer's disease is a condition that

begins in the brain decades before the

first symptom, it's like the idea that

you're going to reverse that is I mean I

wish we had the capability of doing

that, but I just don't think it's I

don't think it's possible once that the

level of pathology has mounted to such a

staggering degree that you're starting

to show symptoms. It's like at that

point the train has left the station.

But it's also important to differentiate

between what symptoms are, right? If we

if we keep putting out there to the

world that the first signs of cognitive

impairment and Alzheimer's disease is

loss of short-term memory, then

everyone's going to be rushing to the

doctors, right? Um, today I I did a

podcast, I couldn't think of a word.

That doesn't mean I have Alzheimer's

disease. It could mean that in that

moment in time I could be sleepd

deprived and I'm just not thinking or

focusing correctly. So there's more than

just, you know, episodic memory. But

interestingly,

something that is just so wild to me is

lacanomab right now. Did you read the

the New England Journal of Medicine for

the patients that actually underwent

lacanab and

it's not it wasn't a home run by any

stretch. It was

so it's an introvenous IV uh which is

the FDA pharmaceutically approved drug

for Alzheimer's disease. And um

basically what it does is it goes in and

it you can see a removal of amaloid

itself. Right? So we can see the removal

of it but what ends up happening is a

the removal of amalloid doesn't actually

result in getting your baseline

cognitive functions back up and running.

Right? So what was the point of it? B

you're actually getting a loss of brain

tissue in that process. See, most of

these patients experienced micro

hemorrhages from the brain. So, they're

getting brain bleeds by taking this. So,

if we can't even get to a point where we

can find a cure, and by the way, this is

a $30,000 um IV, which actually has to

be administered at least, was it once

every month or at least four times a

year, sitting in the hospital bed

removing amaloid. You're they're

actually removing around four grams of

amaloid in the brain.

Wow. Which by the way, I don't think it

was all amaloid. Like four grams is a

lot. Yeah. Right. So you think they've

definitely taken away some brain tissue

with them as well. So you're actually

under more harm. And there was deaths

recorded from this drug as well. So

you're under more harm if you get the

disease and decide to go down that route

of um doing the treatment.

It's crazy. There's um yeah, I mean I

think it's like it was like a viable

hypothesis or like at least at the very

least it made sense and the the drugs

have been tried but you know succeeding

at removing this protein from the brain

without improving the first of all but

with the with increasing potential brain

bleeds, death. I mean that that who

would want that for their loved ones

without even a concurrent reduction or

improvement in like the clinical

symptoms. To me it's just like okay

we've tried it. It's not working. We got

to move on. It's similar to like it

makes it made me think of when you were

describing the the study the um you know

for a long time it it seemed to appear

that higher levels of HDL

was protective of you know

cardiovascular disease and I think high

high HDL relative to low HDL it's a

surrogate for health

but then they tried they they developed

drugs that succeeded at actually

artificially boosting HDL but they saw

that there No. Uh that it didn't seem to

improve cardiovascular outcomes.

Yeah. And doesn't it actually increase

your risk of cancer? Having a really

high HDL

that I don't know that I'm not sure

about. But I I mean high low HDL is a

you know is one of these indicators of

of metabolic syndrome. Yeah. So we want

our HDL to be high because we because it

reflects like

vigor health. Um but yeah, we don't I

mean we don't really understand why.

It's just that and and also when we when

drugs have succeeded at raising it like

it hasn't really done much for for heart

health outcomes.

Exactly. So there's just so much at play

here. And I always say that with lipids

which we can get into it tells a story.

So not a one-sizefits-all approach,

right? Okay. So we've got the we've got

the FDA approval drugs that we know

don't work, right? So then we have to

really think, okay, what can we be doing

every day? And we now have substantial

evidence to show that resistance

training, building strength and muscle

is going to serve you. It is going to

save your life. It is a longevity organ

and it is a brain health organ as well

in my opinion. And that is truly because

of the myioines. But what I want people

to know is that you should go to the gym

for your brain. It's the journey. It's

not the end product of actually building

muscle or the end product of getting

fitter. It is the journey of what takes

place during that time of you

contracting your muscles over time under

tension. It's because of the fact that

you're getting a more blood flow to the

brain which is what we need. Uh you're

strengthening the arteries. We know that

the corroted arteries that comes off the

aorta goes into the brain needs to be

really strong and durable and flexible.

And the third thing is because of the

myioines which are in my opinion they

are like the ultimate free natural

pharmaceuticals that your brain needs to

thrive

is BDNF one of those

brain derived neurotrphic factor yeah

that's the most abundant and well-known

one and we can get into that when we

talk about aerobic exercise but I'm

talking about cathpsum B I'm talking

about irri uh I'm talking about is 6

which we thought was a pro-inflammatory

cytoine but we know that when it's

released from the cells of the muscle.

It's anti-inflammatory.

Whoa.

Yeah. Which is like monumental, right?

So, it it goes into the brain and

becomes anti-inflammatory. So, it can

calm you down because neural

inflammation is a huge factor in these

diseases. But these myioines is a

double-edged sword, right? Because we're

now seeing all of the research on myoc.

So uh one of the the best studies was

printed in nature where they showed that

these myioines when released from the

cells of the muscle during resistance

training can mitigate uh prostate

tumors.

Whoa.

Yeah. So you've got receptors all over

your body and organs for for these

myioines.

So would you say is it fair to say that

exercise is is a form of medicine?

A form it's exactly what I say. That's

my motto. Exercise is medicine.

Wow.

Yeah.

I love it. So the the the myioines that

that you've named irres

forget the others

B.

Yeah. The those are stimulated primarily

from resistance training.

Yes. Because when they're in the cells

of the muscle, right? You myioine you

have to contract your muscle but you

can't do it you have to do it under

force.

So then we then think about okay how

much force do we need? This is why

lifting heavy is more beneficial for

you. Not just because we are growing and

are growing our muscles, but because to

release these myioines, you need to

place your muscles under tension. So,

I'm generally trying to push people to

lift at around 75 to 80% of their one

repetition max.

It's pretty heavy. Yeah,

it's pretty heavy. But if you stick to

doing five reps or six reps, you'll get

there. And pretty much you want to at

that sixth rep, you want to like have

around two reps in in uh in reserve.

Reps in reserve.

Reps in reserve. Yes,

man. So, what I mean, what a if there

are people listening to this that are

like, “What? So, now I've got to start

to train like a bodybuilder to protect

my brain.” Like

I'm sure people are probably some some

are probably maybe the people of an

older generation are pro, you know,

possibly listening to this

cynically

and and thinking, well, look at the, you

know, these are two young people. They

probably enjoy working out, lifting

weights. Um, but how would you Yeah. So,

how would you address those concerns

that like, you know, that resistance

training is maybe weightlifting like a

bodybuilder, it's just a fad because of

the rise of the wellness industry and

and fitness memes and things like that.

I mean, there's a reason why uh the

fittest people live the longest, right?

Those with the higher recording of V2

max have end up living longer. So, we

have to think, okay, there's something

to this, right? And then resistance

training, you don't it's that's another

thing. We're scaring people away from it

by saying you have to live heavy. You

have to lift every day. In fact, when

you actually look at the studies, it

shows that at minimum minimum it's just

two days a week. That's not a lot of

time. And I'm not saying to go in there

and pound yourself in the gym for hours.

You can do everything in 45 minutes at

the gym. That is necessary for a healthy

functioning brain.

And the best way to describe this is go

in and learn how to do compound lifts.

Stop thinking about body. Bodybuilders

are doing these accessory muscles,

right? You see them there. And when I

see a woman at the gym doing this, you

know, working on her wrist strength

because she's seen it on some real, I'm

like, “Oh, hell no.” Right? Lift. Like,

if you can learn to squat, learn to

deadlift, learn to bench press. Those

three are the most important exercises

for women. Learning how to do them

properly. because when you learn how to

do them properly, then you can just keep

stacking the weights on. So, they're

compound movements that you want to be

doing at the gym.

Compound movement. Basically, a movement

that works multiple muscle groups at

once.

Yeah. Like the squat. Yeah.

Right. Barbell squat.

And I love the emphasis on on the word

learn. Le learn to do them properly

because I mean there are plenty of

people I mean you could toss a stone on

social media and and hear stories of

people injuring themselves with these

with these moves as well.

Yeah. But you're getting an and another

effect that females are getting as well

is we have estrogen receptors on our

bones, right? So we this is why women

experience osteopenia and osteoporosis

as they go through the menopause

transition, right? So they're getting a

they get their bone mineral density is

getting low and low because of the loss

of estrogen regardless of them taking

HRT or not. So being able to stimulate

bone through resistance training is also

going to help them. Fun fact, there is a

group of researchers in New Zealand

working with menopausal women and bone

density. And this one researcher

actually put a program uh forward for

females postmenopausal over a 10-e

period. She got them jumping for 10

minutes three times a week. Just jumping

on the spot. Nothing crazy, not with

weights or anything. And she took women

who were osteopenic to normal bone

density in 10 weeks.

Wow.

Yeah.

From jumping. Just the impact

because Yeah. You're stimulating the

bone to recreate itself every time you

jump. So women should now also include

some form of plyometrics, right? Because

that's what it really is. But it doesn't

have to be crazy. It just has to be

jumping up and down on the spot. Um,

back to my mother, we did a bone density

scan on her and she has a t-core of

minus 2.5, meaning that she's minus 2.5

below the average of her age group. So,

I've got her jumping for 10 minutes a

day. If you want to be really

coordinated, use a skipping rope.

H I learned how to jump rope in 2020.

It's not It's not easy.

It was not easy. No, I mean, it's like

uh one of these coordinated things. It's

like it works. their brain works myriad

muscles.

Yeah,

not easy.

No, not easy. But then we've also got

another thing which let's clear up now.

I think there's also something else

happening with women where they're

spending so much time doing hit

training.

Okay, so we've got certain zones when

you look at exercise physiology just to

determine heart rate metrics, right? So

zone one is what you and I are in now,

which is sitting. If you go all the way

up to zone five, that's that I call it

the spew stage. Like if you get up

there, that's your maximum heart rate.

You kind of want to throw up, right? And

in between that, you've got zone 2,

three, and four. So many women are

spending their time in zone three and

four, and for the life of me, they're

wasting their time.

What does that look like? Like a jog?

That looks like hit training at uh

Orange Theory.

Got it. Orange Theory. Okay.

Right. So over a 45 minute to an hour

period of time, they're not in zone two,

which is that steady state, they're over

here in zone three and four, but they're

not in zone five. And what they're doing

is they're just they're just producing

more cortisol, right? So women in the

post-menopausal stage or even in the

permenopausal stage already have higher

inflammatory markers, right, due to

lowering of estrogen, right? So then

they're going to go and put themselves

under even more stress due to all of

that cortisol fluctuating. It's actually

not doing anything for them in the long

term in terms of making them fitter,

making them more cardioabolically

fit.

I don't agree with it.

So is it because they're doing too much

of that in intensity?

Yeah. So what we know that actually

really enhances your fitness and what

women need is to be getting in that zone

five. Okay. That one that is actually

hard out efforts which is going to

increase your V2 max. Post-menopausal

women have a

triple risk. They they their risk

triples by their risk triples of getting

a heart attack during that and getting

cardiovascular disease during the

menopausal period. So being able to have

an effect on your heart and being able

to protect it in this zone is much more

beneficial than wasting your time in the

zone 3 and zone 4.

And the good news about I mean people

might say oh zone five I mean that

sounds even more difficult than an

orange theory class. But the whole thing

is like you're only in that at that

level of int you're only doing work at

that level of intensity for like brief

bursts, right?

Yeah. Like four minutes on three minutes

off complete rest. You repeat that four

times and you're done.

What about like when I'm doing battle

ropes? I love doing battle ropes, but I

can only sustain my highest level of

intensity when doing battle ropes for

like 45 seconds.

Exactly. But is that your heart rate or

is that just your muscles fatiguing?

All of the above.

Exactly. But if you to do your maximum

heart rate on the step machine, which is

where I do my V2 max efforts, you

probably could sustain that for a longer

period of time. And by the way, when

we're talking about the 4 minutes on,

that's really it's taking you about a

minute to get your heart rate to that

level. So, you're probably really

getting your heart rate to that maximum

for around a minute and a half.

Got it.

So, like what would what would that look

like with like battle ropes or like an

assault bike? Could it be in total four

minutes on the on the machine, but like

in terms of the work that you're doing

like

hard cycling or hard

swinging of the ropes for like

a couple seconds with a rest period in

between and then doing that a couple of

times.

Correct. Yeah. And with the rest period,

it has to be a complete like sessation.

You have to like completely stop and get

to a a rest period of around 3 to four

minutes as well.

Yeah.

And so that that seems to be really

effective for boosting V2 max.

Yeah. The Norwegian 4×4 is the gold

standard in improving V2 max. There see

well, you know, in those studies of

improving V2 max, you can still improve

it with uh a minute on a minute off,

right? It's just not as large of an

improvement. So, if you're looking for

your biggest bang for your buck, it's

doing the Norwegian 4×4.

That's really great news because I think

a lot of people might wrongly take away

from conversations like this that you've

got to make fitness your full-time job.

Yeah, exactly. And um it's certainly not

my full-time job, but I do dedicate a

lot of time to it. Um but even with the

amount of time that I dedicate to it,

there are definitely like zones of

cardio exercise that I neglect. Like I

sp I do a lot of zone 2 and I resistance

train, but I do not do enough zone 5.

Yeah, I don't.

And there's also a lot of women spending

their time in zone 2 as well. And that's

because we've seen this rise of zone 2.

Okay. I interviewed um Ini Inigo San

Milan as well and he was he's a a cancer

metabolism expert and you know he even

says that we've seen this huge rise in

zone 2 and we have but again that's

geared towards men. Women don't really

need to be spending their time in zone

2. They need to be spending their time

resistance training jumping and doing

zone 5. Zone 2 should be the supplement

to a female's exercise regime. Meaning,

if you have done all of the work

throughout the week, and on Sunday,

you've got spare time, go and take a

ride with your kids on the bike, do your

zone two, go for a long walk. That

shouldn't be the dedicated Tuesday

morning exercise time spent in zone two.

So, do you have like a do you what are

your thoughts then on like the daily

step goal?

Oh, I do believe that. Like yeah, if you

we know that um step count is strongly

related to both longevity and

Alzheimer's disease. So if you can be

meeting 8 and a half thousand steps, I

believe it is at minimum per day, then

yeah,

that's pretty good.

But you're also get you're doubling up.

If you get outside, you're getting the

sunlight as well.

Right. So we've spoken about we've

spoken about exercise, aerobic exercise

as well to you know can definitely have

yield massive amounts of benefits. The

one thing I'll tell you again with the

zone five, what you're doing as well,

you're having a huge impact on cancer

and cancer metastasis, you're also for

for anybody who is actually going

through chemotherapy.

The chemotherapy is actually going to

work better and you getting out of the

hospital faster if you also incorporate

exercise into your regime as an adjunct.

Yeah, our mutual friend uh Joe Zandell,

cancer cancer biologist. He's like a big

exercise advocate.

All roads all roads seem to lead back to

the many benefits, the multi-acceted

benefits of adopting and sustaining an

exercise routine.

Yeah. And when you're working out at

that high rate, many of us, actually

almost everybody's walking around

unknowingly, okay, we don't know if

we've got a tumor present somewhere,

right? because you can't pick up on

stage one cancer or these tiny tumors,

at least to my knowledge, through an MRI

scan, right? Because then we'd all be

diagnosing, right, and getting there

faster. So, what happens in stage one is

you've got tum one tumor there and these

circulating tumor cells circulate

through your body because the tumor

breaks off and it tries to go and find

another way to lodge itself and that's

called metastasis. And during that

process, you've got pieces of this uh

pieces of this tumor circulating through

your blood. These circulated tumor cells

can actually be obliterated through

highintensity

anorobic work because the shunting and

the sheer force of the blood that goes

through your body when you're exerting

yourself at that level has the potential

to clear out those circulating tumor

cells

and we've seen this in trials. This is

not my my opinion obviously but I think

that that's really powerful too.

Super. Yeah. I mean cancer is

terrifying. I heard it once said that

you basically want to train all of your

different I mean everybody kind of has a

sense of the of their

of what the the various intensity levels

of exercise look like or feel like

and um and it's you know totally

subjective but like I know when I'm

giving my 100%. So, I heard it said

recently that you want to basically

train all of the the different

intensities.

Like, it's not enough to just do to just

do zone two and to focus on walking,

being quoteunquote active. Like, if

you're not challenging your

cardiovascular system with some of that

higher intensity stuff,

then you're I mean, you're leaving a lot

on the table. I guess it's probably

going to impact your longevity.

Yeah. You want to try and get into every

system, of course, because just like

your brain, your heart loves variety. I

mean, your brain loves variety. This is

why it loves to be in different areas

having different challenging

conversations and staring at different

things. It loves variety and that's how

it grows. That's how it thrives and

that's how it maintains its structure.

So, that's the same for your heart, your

cardiovascular system.

So important. And when it comes to So,

should we talk about nutrition a little

bit?

Well, of course. I mean, that's your

domain, but I I have a few things in

that aspect that we can uh

well, I I definitely want to talk about

it because I saw this uh this headline

recently that actually made me feel kind

of optimistic. It's rare that you see a

headline, like a viral headline that

that gives you actually like a warm and

fuzzy feeling. But the headline was that

we're currently in the midst of sardine

girl summer.

Yeah, I had no idea.

Sardine Girl. So apparently sardines are

now trending as like a

food dour on social media which is

actually kind of amazing and the

headline conveyed this to some degree

that sardines are actually a really

nutritious food that can help ward off

Alzheimer's disease, cardiovascular

disease, etc. What do you make of this

trend?

Oh my god, I love it. I mean it's so

much better than the like other things

that have been trending, right?

Yeah.

So I think this is great because it's

now bringing awareness towards the fact

that fatty fish may be good for your

brain. So, let's unpack why that is.

First of all, your brain is around 2 lbs

and it takes up around 20% of the total

calories that you ingest every day. It's

made up of fats and proteins, right? And

if we think about that, that's around

60% all of your total brain is made up

of fatty acids. 10 to 15% of those fatty

acids is made from omega-3 fatty acids,

but specifically DHA, right? So, we've

got EPA, DHA, and ALA. So, your brain 10

to 15% of that 60% is made of DHA,

right? And that comes from fatty fish

like salmon, sardines, mackerel.

So, why does this have an effect on

Alzheimer's disease, right? So one thing

that DHA does is it actually goes into

the cell membrane of the brain cell and

it protects the brain cell in many ways.

It has a huge anti-inflammatory effect.

The second thing that it does is it

helps with cell membrane fluidity.

Right? What does that mean? It it helps

with cell membrane fluidity at the site

of transmission. So earlier when I said

that cells communicate with each other,

there's around 15,000

communications per cell, right?

When one cell communicates with another,

they release chemicals. They're called

neurotransmitters. We've got serotonin,

dopamine, um we've got uh NMDA receptors

that are responsible for different

things. We've got GABA, which is

responsible for calming you down. So if

we have better cell membrane flu

fluidity, we've got better synaptic

transmission of these neurotransmitters

and that's a better working memory.

That's better. Like every cognitive

domain is going to benefit from greater

neurotransmission.

Exactly. And it all comes down to the

DHA content in your brain which is

phenomenal. The second one is EPA. DHA.

So specifically EPA is probably more

better for the heart, right? and DHA

more better for the brain. Don't even

want to talk about ALA

because ALA well why why not?

Because it's actually it has to convert

and that's the that's the plant version

of of omega-3 fatty acids. You actually

have to go through a conversion process

from ALA to get into DHA and EPA into

the brain.

So ALA is basically like the plant-based

omega-3 that's a that serves as a

precursor but its conversion in the body

is very limited.

Correct. Yeah. and DHA. And so

otherwise, you have to get your DHA from

food. Like DHA is an essential

fatty acid, meaning your body doesn't

make it. You have to, if you want to

enrich your brain with DHA, you have to

prioritize it in the foods that you're

eating.

Yeah. And like we said, polyunsaturated

fatty acids are the predominant fat in

your brain. uh when the so when the DHA

is actually released from the brain cell

it it serves as a as a potent

anti-inflammatory as well I would say

that it's it is miles ahead of an NSAID

an anti-inflammatory okay I think it has

like it's even like even the studies

that have been done on life extension

from EPA DHA this is out of uh Dr. Bill

Harris's lab. He's the one who

formulated the omega-3 index, which he

showed that if you have an omega-3 index

of 8% or more, you can add on at least I

think it was a 5year life extension. So,

which funnily enough, right, so in the

US, the average omega-3 index is around

4% or less. In Japan, the average

omega-3 index is 8% or more. Mhm.

Funnily enough, Japan has a 5year

increased life expectancy over the US.

Wow.

Yeah.

I actually know my omega-3 index. I had

it measured recently. Let me see if I

can pull it up.

Mine is um mine's 11.8.

11.8. Yeah, that sounds pretty good.

Yeah, it sounds pretty good to me, too.

Um let me see. Omega3

index.

Can I find it? I don't know how I'm

going to find it, but I definitely

posted it recently. Yeah, it was pretty

good. Yeah,

it was really good. It was in the It was

in the positive range. Okay, so

you want to make sure you want to test

your omega-3 index.

You want to It's such a simple pin prick

test. You just

you get sent in the test home um and you

put your a dot of blood on this little

piece of paper, you send it back, and

then they give you your they give you

omega-3 to omega 6 ratio, etc. And then

then you have a baseline of what to work

on. Now what do the studies say?

Randomized control trials. Most of them

in terms of dosages have seen that if

you dose uh there was one study which

had 176 older adults, they dose them

with just one gram of DHA per day and

they saw massive differences in their

cognitive functioning in terms of speed,

processing, episodic memory. And then

they did another one with around 485

participants, older adults,

and they saw and they supplemented them

with 900 grams. Right. So

900 g of

900 milligrams. Sorry. Yes. 900

milligram.

Say that's a lot.

Yeah. So the general consensus is I

believe everyone should be having at

minimum two grams of DHA and two grams

of EPA per day. H. And so then why how

does this circling back to sardine girl

summer, why are sardines then why do

they seem so why does it seem like such

a positive trend from a from the

standpoint of a brain health expert?

Oh, because they're full of omega-3

fatty acids. I think they're really low

in mercury compared to other fish.

They're not too expensive. Okay.

Compared to other fish as well. And

they're probably easy to obtain. Yeah,

tinned fish is like a a trending thing

on social media now. I don't really

fully understand.

I usually have skinless ones. No, but

you know what it is? I've noticed a huge

trend in the the packaging of sardines.

I noticed this like two years ago.

Sardines just used to be in a in a

boring package, right? And so did cans

of tuna. Now these packages cuz I

remember I walked into I live in New

York and there's this place in the East

Village. I walked in there and there's

like this all these designer labelled

sardines. Patagonia actually has their

own line of fish now.

Interesting. I think I think I've seen

that. Yeah,

that's great.

And they're even getting more expensive

now.

Interesting. Because of the demand.

Because of the demand and because of the

packaging.

Oh,

yeah.

Yeah. Sardines are are great food. Um,

but they're also like, you know, I mean,

not not everybody has warmed up to the

to the to the palatability of sardines.

Yeah. And so, the other thing is we, you

know, we have to be cautious of where

we're getting our fish from, right?

Because you could say, “Well, Louisa,

why can't I just load up on a bunch of

salmon?” It's like, “Well, to meet the

requirements, which I mentioned is

around two grams per day of EPA and DHA,

you have to eat a lot of fish.” And a

lot of the fish that we're having is

farmed. So, it's probably derived of any

nutrients, right?

I don't I mean,

deprived of any nutrient.

Yeah. I mean, it's like, yeah, the fish

that are farmed fish, I still think it's

better than eating no fish to eat farmed

fish, but I get it that a lot of people

choose to avoid it because of I don't

know whether it's microlastics or PCBs.

Um, farm fish are fed pretty they're fed

like basically pet food.

Exactly.

You know, like pellets. Yeah.

Yeah. So then um then we have to then

talk about sourcing of um omega-3 fatty

acid supplements because we know that

the supplement industry is highly

unregulated. We're seeing tons of

omega-3s specifically that are becoming

rancid because they're not stored

correctly. They're not in glass jars and

we don't know where they're coming from.

So, you have to make sure that whenever

you are checking your supplements or

your supplement stack, you want to make

sure that you're getting it from a

company that uses third party testing.

Actually, one of the best apps has

actually just been released and it's

called Subco.

I've heard of it.

Oh my god, it's phenomenal. So,

basically what you do is you go on there

and they have this score on there. So,

they've gone and done all of the testing

of all of these products, okay, from

many different um manufacturers and

brands, and they've given them all a

score, 10, 9.85, all the way down to

like a zero. And it's probably the best

thing that we have, the best tool

available because it does the work for

us and it's completely free. So, all you

have to do is go on there and you can

write in omega-3 fatty acids and it

comes up with the scores and it gives

you the the products and the brands,

etc.

It's called Subco.

Subco, SUP PC Co. Interestingly enough,

they did um they did a test on some of

the biggest creatine gummies out there.

Now, guess what?

Spill a tea.

It turns out that there's no creatine in

these creatine gummies. All of them or

just like some of them or

the the top three ones sold on Amazon.

Whoa.

Yeah.

Yeah. Buying supplements on Amazon is

sus. Like you got to be really careful.

Yeah. This one guy actually compared he

bought the real Thorn supplement and

then he bought the Thorn supplement from

Amazon and he looked at them and it was

the exact same label and the exact same

supplement. They looked exactly the

same, but the bottles were completely

different. So, which means that

somebody's gone out and they've copied

the the Thorn label and they've printed

them and put them on these shitty little

bottles and they're probably just

selling you I don't know what they're

putting in there.

That's scary.

Yeah.

I when I go when I look when I go to

Amazon to buy supplements, I will see if

at the top like if I were say I was

going to buy a Thorn supplement, which

everything I've heard about Thorn is

that they're it's a very reputable

Well, on Subco, if you look, most of

them are at the 10 or the 9.85. Wow.

In terms of quality.

Interesting. Yeah. So, I mean, you're

always better off, I guess, buying from

the manufacturer's website.

Oh, yeah.

Right.

Yeah. Always better to do that. But not

just that, you really want to if you if

you don't go on, you know, Subco, you

really want to make sure that every

brand has been doing third party

testing, NSF certified, but not just

that, you want at least two or three

different um governing bodies. I uh use

Peori and um they're one of the partners

on the show, but I love Piori fish oil

because it's IO certified.

Yes.

And um and I think it might even be NSF.

Don't quote me on that, but they go

through

they you know many different hoops to

make sure that their their products are

third party certified. And I think I

when it comes to fish oil specifically,

IOS is great. It's the international

fish oil

standards. And um and they test for

contaminants, they test for purity, they

test for potency, they test I believe

they test the tottox, which is like

basically the the level of oxidation in

the pills

because that's really important, right?

Like omega-3s are are

highly oxidized,

highly vulnerable to oxidation. So

yeah,

that's definitely something you want to

be careful.

Yeah, exactly. Um so yeah, so keeping

with that theme, I think that when we

are looking at certain quote unquote

brain foods that are good for preventing

Alzheimer's disease, it would you're

definitely going to be getting a lot of

bang for your buck if you you stick to

the sardine goal. Hell

yeah idea.

I have a I have a a controversial a

possibly controversial hot take. Walnuts

seem to get a lot of uh love on social

media for being a brain food. I think

primarily because they look in a way

like brains, but I think that they are

actually a pretty crappy brain food.

Isn't the best um nut for our for our

body pecans or pecans?

Pecans. pecans wherever you are in the

world.

Tomato, tomato.

Yeah.

Um I think Oh man, so this is this is

super like nerdy, deep cut, but I think

that my two choices for the healthiest

brain healthiest nuts would be

pistachios and almonds.

Why?

Well, almonds because they are the

they're a top source of magnesium. So in

about in one serving of almonds, you get

25% of your

uh daily magnesium needs, which is

really important for DNA repair and

energy production. And they're also

loaded with vitamin E, which is a really

important antioxidant for the brain

specifically.

And then

um and I don't even count the omega-3s

and nuts because they're the plant

omega-3s. So, that's Wal walnuts claim

to fame is that they're the richest in

omega-3s, but they're like the

plant-based omega-3s.

And I don't know who said this, but I've

seen that um now a lot of people are

scared about the the mold on nuts. Is

that a thing?

I've heard of that. I don't know. Yeah,

probably. I mean, there probably is

some, you know, unless you're

somewhere along the lines.

Yeah, but I wouldn't be I wouldn't be

too concerned about it because

observationally people who eat nuts seem

to have better health. Like, it's pretty

it's a pretty universal observational

finding. Um, so I wouldn't be too

concerned about about the mold. But then

pistachios, here's an interesting fact

about pistachios. Pistachios are the

only nut that contain um lutein and

zeazanthin, which are the carotenoids

that are also really important for brain

health as antioxidants.

And pistachios, because they're

yellowish and green,

they contain those plant pigments, which

other nuts do not contain.

I heard um that Dubai is actually uh

under a pistachio shortage

because of the Dubai chocolate. because

of the Dubai chocolate.

What is that? I keep hearing.

I have no It's just I guess it's just

It's mashed up. I don't know. Mashed up

pistachios inside a chocolate bar.

That's I've never had it before, but

that's what it looks like. Yeah,

it looks pretty It looks hyper

palatable.

Yeah.

And uh like something I would not be

able to moderate

my consumption of.

Um Okay, so omega-3 is super super

important stuff.

Yeah. Um, what are some other brain

foods that I mean as a as as somebody

who knows the value of preventative

brain care? Like what give me some other

items in your shopping cart like your

weekly grocery haul, like what are you

putting in there with your brain health

in mind?

Uh, I'm putting in blueberries. Okay.

Um, we we've seen so many uh multiple

studies that show that blueberries are

phenomenal polyphenols for the for the

brain. I just um I'm going really deep

now into olive oil and olive oil and the

politics around olive oil. Okay, so

olive oil is is phenomenal for overall

brain health and body health and

longevity. But there is now a it's now

known that there's no such thing as

first pressed or coldressed olive oil.

And I was under the assumption I was

buying, you know, extra virgin

coldressed first pressed olive oil and

that's not a thing now. So now I'm

actually looking at labeling of that.

But just to cut a long story short, I'm

having a lot of olive oil with my food.

I am having a lot of I do eat a lot of

red meat as well. I think that that is

in in my opinion, it serves as a great

brain food. I don't uh I will admit I'm

having a lot of fruits and vegetables. I

I I'm an omnivore. And so that's what's

I'm I'm a very whole foodsbased diet

girl. I do have a a chocolate problem,

but uh it's a it's a daily little piece

of chocolate consumption. And

some of the some some would say dark

chocolate is a is a brain health food.

Exactly. It it's it's like 60%. It's not

the 70% uh 70% one. But other than that,

like I don't smoke. I don't drink. Um I

eat I eat really healthy. I never eat

processed foods, ultrarocessed foods.

Now, is there anything that you do to

keep tabs on your brain health? I mean

beyond just like the subjective

experience of being, you know, a high

performer, a public communicator,

um an educator, like are you routinely

testing your your cognitive health in

any in any way?

Yeah. So I do a lot of things. Actually,

this is a really great uh time now to

talk about something that is available

to Americans. Uh unfortunately, it's not

available anywhere else. We now have

blood tests to actually determine if you

have amalloid in your brain and tow

proteins.

Wow. Via blood.

Yeah. Via blood which is actually right

now just as effective as getting a PET

scan or getting a spinal tap. So what we

used to have to do to actually diagnose

Alzheimer's disease and see if there's

amalloid present in your brain is doing

a spinal tap getting some of the

cerebral spinal fluid which is invasive

right cerebral spinal fluid and then

measuring how much amaloid is in the CSF

we can now do with almost exact same

predictability we can do it through a

blood test

that's amazing

yeah I think it's uh is it pal 217 or

yeah pal 217 so we can actually now

measure measure the amount of amaloid,

neuroilament light, NFL, and tow just by

getting a blood test.

That's amazing.

I know.

Do we Is it something that's being used

clinically? Do we know if insurance is

currently paying for it?

I don't think insurance is paying for

it. I correct me if I'm wrong. I think

it's around the $600 or $700 mark. But

look, we've seen people go in and do it

aged 50 go in and do it and they've got

mild amounts of amaloid and towel,

right? So, it's interesting to see that

at such a a young age, but that can

also, you know, because that small

amount can cascade. You never know in

your 60s. So, then you can start to get

on the the bandwagon of, okay, what can

I do to to maybe prevent it, eliminate

it? So, this one specific person, what I

know what she is doing is she's going to

go and do one of the plasma exchange

sessions. So, where you go in and um

they basically take many liters of blood

out, they separate the blood, the red

blood cells from the plasma, they get

rid of the plasma, which contains all of

the the gunk that builds up. And I know

Brian Johnson's done a lot of this and

he shows his bags and they're completely

yellow. They get rid of the plasma, they

put the red blood cells back. So

basically you're washing your blood

and in that process you can actually

eliminate the amaloid and the towel.

That's fascinating.

Yeah, I'm actually thinking of doing it.

Not that I have any um amaloid or tow

which is funny. So I actually did the

test and it it zero. So that's great.

That's one thing I'm doing. Yesing. Um

I did a full body MRI and that was in

September last year and everything was

fantastic.

What did that didn't reveal anything?

Didn't reveal amazing. No, it revealed a

a tiny nodule uh nodule on my thyroid.

I had the same thing.

Yeah, I went and got it scanned um with

ultrasound. Yeah, I did an ultrasound

and I had a little thyroid in my lung as

well.

Little benign.

Damn.

Yeah.

Yeah, that was uh that was kind of

freaky to find out that I had uh

nodules. Is that what they're called?

Thyroid. Yeah, but benign like 99 plus%

of the time they're benign.

Correct. But um that's actually

something that I'm probably going to

maintain. Something else that I'm going

to add to my bucket, which has actually

got nothing to do with brain health, but

I'll add it in there because it is

imaging. Uh in Australia, I was just

home last week in Australia, they've

just released as of 2026, the government

is now going to be paying for uh

lowdosese CTS of the of the lungs. And

that is because people younger and

younger are getting diagnosed with lung

cancer

irrespective of smoking status. Wow.

I know.

I wonder why.

I mean, it's uh it's definitely up there

of one of the leading causes of death,

obviously um in cancer,

but it's just it's so scary to know that

you can be a smoker your whole life and

never get it, but you could also be a

non-smoker and get it. So, um

it is crazy. I mean, it's very it's

humbling when you hear stuff like that

because it's like similar with skin

cancer. I mean, you hear people all the

time that were sun avoidant being

diagnosed with melanoma or or or or

being diagnosed with melanoma in sunna

parts of their bodies.

Like I think Bob Marley was famously

like he had it under his toenail or like

at the bottom of his foot or something

like that.

Exactly. And so you just never know. Uh

I'm doing everything I can. People call

me paranoid and I'm like I'm not

actually paranoid. I'm like I I mean I

do this for a living. It's great to talk

about it. Um, I'm I'm not I don't

consider myself paranoid in any way. I

just stay ahead of things. And I

actually think it's fun to see like with

the omega-3 index, right? I was at uh

two years ago I was 10.5. Now, um this

year I was at uh 11.6 or whatever I said

11.8. So, it's interesting to see that

some of the protocols that I do have an

effect. Uh, and then other than that, I

do a lot of cognitive training of my

own, which involves brain body based

workouts. So, I'm doing a lot of that.

What does that look like?

It looks like getting a tennis ball and

an eye patch, which is like $5 from CVS,

literally closing out half of my brain,

and throwing the ball to the wall and

doing various different types of skills

to help my reaction time and processing

speed, my coordination. Um, I'm even

doing ones with lights where um I throw

the ball on the red light and I don't

throw the ball on the on the blue light.

So, that's helping me a lot as well.

Interesting. I heard a couple years ago

that being able to balance on one foot

was a

a sign of longevity

maybe. Yeah. Something like that.

And that's that's interesting because

the cerebellum, which is the mini brain

that sits below your brain and it's

attached to your brain stem, is involved

in posture and balance and control as

well. And that's probably Yeah, that can

deteriorate during Alzheimer's as well,

too.

Damn.

Um, so they're the things that I'm

doing.

No, I love it. It's so thorough. Do you

think there's any aspect of these blood

tests that could just maybe make matters

worse if they if it stresses you out? I

mean, some people, you know, like, for

example, when I found out that I had

these thyroid nodules, I'm glad that you

brought that up because it's like I it's

that's something that kind of freaked me

out even though I know that I'm really

healthy, but up until the point at which

I got the ultrasound, which was like

basically showed that they were just

totally benign, um, I was a little

freaked out about it. I was like, why

the hell do I have these like not, you

know? So, I'm just wondering if you get

these if you get a blood test and you

discover that you do

happen to have some plaque in your

brain. Um,

what do you do about it?

What do you do about it? Like, is that

going to stress you out and cause like a

vicious spiral?

But that depends on who you are, right?

Because and getting an MRI is it's not

pretty and it's kind of scary, right?

So, you have to go through that. So,

that's one part of stress. But then you

have to be okay with what you're going

to find that I was scared of. I'm like,

“Oh, what could I find?” Right? And then

what if you do find something, but it

turns out to be nothing

and you go and chase all these doctors.

So, you have to be able to be okay with

with what's to come. And I say this as

well about people who want to get tested

genetically for the APOE E4 gene.

There's genetic counseling available uh

for people who are afraid of it. Uh

we've got um there was a woman who was

so petrified of doing her uh checking

for Huntington's disease because her

mother had it and she didn't want to go

and get tested because she has two kids

and she said I know that if I get tested

and it comes back positive I'm going to

lose time with my kids knowing that I

have Huntington's disease. Right? So you

just have to know who you are and other

than that um I think nothing is really

going to change if you even if you have

the APOE4 gene right if you have

something that means you have to

aggressively manage lipids right you

have to really go hard on in my opinion

I don't know if you're different to this

but having an LDL less than 75 would

probably be sufficient if you have the

APOE4 gene that's what we've we've seen

in studies

um so that would managing your

lipoprofile. Maybe it means going on a

on a statin for for that purpose. Maybe

you have familiar hypo hyper

cholesterolmia that you might have to go

on a statin for to lower it because

nothing else is going to help.

That's a that's something to talk about

with your doctor. But there's so many

different avenues. Um and then even like

with cancer, we've got this in the

United States. We've got the um what's

this test? the Grail test, which is

still in in its infancy, but the Grail

test can now pick up on different

markers of tumors.

Oh, interesting.

Yeah. So, we're getting closer. Imaging

obviously would be the gold standard,

but we still can't see many things on

imaging like pancreatic, ovarian,

right?

Um

I'm an I'm an APOE4 carrier and my LDL

is certainly not below 75, but um but

it's not super high. I think it probably

runs at the high

like at the high end of the normal

range. Um, and

but what's your APO be?

That is that hovers around

80 to 90 like somewhere in that window

if I recall correctly.

So don't quote me on that, but I think

like around there.

Um,

but yeah, it's not really I'm not too

concerned about it. I mean, you know, I

think a lot of this stuff is genetic.

Like I think that there that diet the I

think in many ways the the dietary

impact on these markers can be

overstated. Um

you know the saturated fat is something

that obviously mod modulates apo more

than other nutrients but it's like even

among saturated fatty acids like some do

that more than others. And within the

whole food matrix, I think if you were

to cut out a saturated fatrich food like

red meat for example, which 50% of the

fat in red meat is oleic acid anyway,

which is monounsaturated fat.

What are you missing out on? Like like

what is the what are the risks of

cutting that food out? Like people think

that cutting out a a category like meat

Yeah.

is like a is like a risk-free

proposition where it's all good, right?

like all good to switching to a whole

foods plant-based diet, but it's it's

really not. Red meat is a very

nutrient-dense food.

Exactly. And actually, I I like that. I

like I like saying instead of thinking

so much about what can I be putting into

my diet, think about what you're not

putting into your diet and what is

responsible like like most people are

walking around with a low vitamin D,

right? Most of the US population,

we the precursor of that is magnesium.

Where's magnesium coming from? Well,

it's a seed of the chlorophyll, you

know, plant. So, are we having

magnesium? Are we having are we getting

the sunlight? We getting the vitamin D.

It's, you know, people are just so

concerned about, you know, we've got

vitamin D receptors all over our our

brain, by the way, but people are so

concerned about the next supplement that

they can have. I actually got asked in

the I would say in my my 10 15 year

career I got asked the dumbest question.

Okay, I have to put this out there.

Can't wait for this.

What supplement? This was after I was I

gave a talk on V2 max for uh longevity.

What supplement can we take

to help us increase our V2 max?

Now that the reason why, right, is

because I had just given a a speech with

slides, really pretty slides for an hour

on V2 Max, which shows me that most of

the population is looking for the

shortcut.

Yeah. The magic pill.

Yeah. Imagine if we could go and get a

pill of V2 max at the at Whole Foods,

right?

I would love it.

Yeah.

Yeah.

Doesn't exist sadly. M

um I think cocolavinols have been shown

to boo maybe again don't quote me but I

think there's some supplement

supplements that can boost uh nitric

oxide like that that pathway

but that's a different that's

that's increasing blood flow

there you go

it's it's all very interesting stuff

it's just it's also complex you know I

think it's so cool to be investigators

in this field scratching at the surface

you know just trying to get to the truth

and everybody's going to have different

perspectives and opinions Um, but that's

why I love bringing people who are as

well informed and deep in the trenches

as you into the show because, you know,

it always stretches my brain in the most

amazing ways and I'm sure my audience

really um has benefit benefited from it

as well. So, thanks for coming out.

Thank you. I'm excited. Thanks for

having me on. I'll see you for part

three.

I know. I can't wait. And um I know you

put out a ton of really incredible

content. So, just like I've got one last

question for you before we get to that.

Where can my audience consume all of the

content that you put out on social

media? I know you've got a podcast.

You've got your Instagram account.

Yeah. Instagram, podcast, on YouTube,

and Apple, Spotify.

Love it.

All of that.

And the podcast is called

the neuroexperience.

The neuroexperience. I've been on that.

Yeah.

Actually, I that was some of my one of

my favorite conversations. I think the

last one where we like went deep down.

We did risk factors of Alzheimer's

disease, but uh the next one's going to

be even better.

Can't wait.

Yeah. Well, the last question I guess

ask everybody on the show, what does

living a genius life mean to you?

It is sticking with your purpose,

whatever that is. Because sticking with

your purpose involves uh getting up and

putting effort into your life every day.

So, if you can be a genius at doing

that, then I think you're going to live

the best life.

Hell yeah.

Amen. Thanks for coming out.

Thank you.

Thank you guys for listening. Share this

episode with people in your life that

will benefit from it. And I will catch

you on the next episode. Peace. Hey, if

you like that video, you need to check

out this one here, and I'll see you

there.

How to Protect Your Brain, Bulletproof Your Mind &amp; Prevent Alzheimer’s - Louisa Nicola

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D:2025.08.13

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